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Key takeaways
- CMS reports an initial six-month nationwide moratorium beginning May 13, 2026, with possible extensions.
- Some ownership changes can require initial enrollment under the majority-ownership rule.
- A transaction that depends on a new enrollment needs an explicit feasibility review.
What has CMS announced?
The CMS enrollment-moratoria page retrieved for this article was last modified August 27, 2026. It describes a nationwide home health and hospice moratorium beginning May 13, 2026, covering initial applications and non-exempt changes in majority ownership under the specified federal rule. The initial duration is six months, and extensions are possible. (Source: CMS, 2026)
Why can an acquisition raise an initial-enrollment question?
42 CFR 424.550 addresses certain majority-ownership changes within the applicable 36-month period. Where its new-enrollment consequence applies and an exception does not, a proposed purchaser cannot simply assume the existing agreement and billing privileges convey. Review the exact regulatory text and CMS guidance with counsel. (Source: eCFR, 2026)
What facts should the buyer assemble?
| Fact | Evidence to obtain | Why it matters |
|---|---|---|
| Initial enrollment date | Enrollment determination and records | Starting point for chronology |
| Prior ownership changes | Complete direct and indirect ownership history | Potential application of the rule |
| Proposed transaction | Parties, interests, entities and structure | Classifies the actual change |
| Claimed exception | Supporting records and legal analysis | An assertion is not a determination |
| Billing plan | Proposed operator and enrollment path | Tests the cash-flow assumption |
How should the offer reflect uncertainty?
Resolve the threshold feasibility question before assuming a routine closing schedule. The parties should understand what decision is needed, from whom, and with what evidence. Counsel should draft appropriate conditions and evaluate any proposed interim structure.
Do not use a management agreement, minority step transaction, or alternative label as an assumed workaround. The applicable definitions, cumulative changes, and regulatory facts require analysis. The commercial agreement cannot authorize an otherwise impermissible enrollment or billing arrangement.
How is this different from ordinary CHOW?
The provider-agreement framework in 42 CFR 489.18 and the majority-ownership framework answer related but distinct questions. A stock transaction's treatment under one provision does not eliminate review under another. Read the 36-month rule discussion for the distinction. (Source: eCFR, 2026)
What should sellers do now?
Organize the enrollment and ownership history before marketing. Avoid promises that certification is automatically transferable or that billing will remain uninterrupted. A qualified buyer needs a defensible path, not merely a seller's expectation.
The CMS FAQ explains that existing-provider changes are not all treated identically. Use it as source guidance, then verify the status and treatment of the actual transaction. (Source: CMS, 2026)
Frequently asked questions
Does the moratorium stop every existing agency from operating?
CMS's guidance distinguishes new enrollment applications from existing enrolled providers, which can generally continue participation and claims subject to applicable requirements.
Are all acquisitions blocked?
No. CMS identifies affected initial applications and non-exempt majority-ownership changes. Other ownership changes can be treated differently. The actual history and structure must be assessed.
Can I assume the moratorium ends after six months?
No. CMS states that it may extend the moratorium in six-month increments. Verify the current notice and implications before relying on a future closing or enrollment date.
Who should determine whether my deal is affected?
Healthcare counsel should review the transaction and coordinate as appropriate with the Medicare Administrative Contractor and relevant authorities. A broker or website cannot approve the enrollment path.
Sources
Sources are dated to distinguish current guidance from earlier publications. They support the identified facts; the transaction questions and examples are educational analysis.
- CMS: provider enrollment moratoria (2026). Retrieved September 5, 2026.
- CMS: home health and hospice moratorium FAQs (2026). Retrieved September 5, 2026.
- eCFR: 42 CFR 424.550 (2026). Retrieved September 5, 2026.
- eCFR: 42 CFR 489.18 (2026). Retrieved September 5, 2026.